ITEM Coalition presses for Medicare coverage of standing coverage
By HME News Staff
Updated 9:17 AM CDT, Tue June 18, 2024
WASHINGTON – The ITEM Coalition has reaffirmed its request for CMS to open a National Coverage Analysis (“NCA”) for Medicare coverage of standing systems in power wheelchairs. The ITEM Coalition submitted its original national coverage determination request for coverage of both seat elevation and standing systems in 2020. CMS bifurcated the original NCD request and granted coverage of power seat elevation in May 2023. “While the ITEM Coalition applauds CMS’s decision in 2023 to cover power seat elevation, we have waited nearly four years for CMS to open the NCA for standing systems coverage, and the time is now for CMS to finally act,” said Peter W. Thomas, J.D., ITEM Coalition co-coordinator and managing partner of Powers law firm. The ITEM Coalition is requesting that CMS formally open an NCA as expeditiously as possible to:
- Establish a benefit category determination (“BCD”) that standing systems in power wheelchairs are “primarily medical in nature” and, therefore, covered durable medical equipment (“DME”) under the Medicare program, and
- Explicitly recognize coverage of these systems as reasonable and necessary for beneficiaries with a medical or functional need for standing systems in Group 3 power wheelchairs in order to perform or participate in MRADLs in the home.
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